Provider Demographics
NPI:1457570129
Name:MUSCARELLA, DARRIN JAMES (PA-C)
Entity Type:Individual
Prefix:
First Name:DARRIN
Middle Name:JAMES
Last Name:MUSCARELLA
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 SE MONTEREY RD STE 400
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-4512
Mailing Address - Country:US
Mailing Address - Phone:772-288-2400
Mailing Address - Fax:772-419-0143
Practice Address - Street 1:1050 SE MONTEREY RD STE 400
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-4512
Practice Address - Country:US
Practice Address - Phone:772-288-2400
Practice Address - Fax:772-419-0143
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9117971363AS0400X, 363A00000X
OH50 003857363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0094184Medicaid
OHH201151OtherMEDICARE PTAN
PA1008716530001Medicaid
OHH201151OtherMEDICARE PTAN
PAU71467Medicare UPIN
OH0094184Medicaid